title: Age, symptoms and upper gastrointestinal malignancy in primary care endoscopy.
abstract: OBJECTIVE
  Upper gastrointestinal complaints are common in the general population. The aim of this study was to establish whether age and occurrence of alarm symptoms are predictors of malignancy in primary care open-access endoscopy.
  
  
  METHODS
  The material comprised 10,061 consecutive patients referred for gastroscopy by general practitioners from 1989 to 2000. The presenting symptoms were recorded; alarm symptoms comprised dysphagia, weight loss, gastrointestinal bleeding, anaemia and vomiting.
  
  
  RESULTS
  In all, 13.0% (1310) of the patients had alarm symptoms. Malignancy was detected in 0.7% (72 patients) in the whole series, in 0.3% (13 patients) aged 55 years or younger and in 1.1% (59 patients) over 55 years of age; the respective percentages in patients with alarm symptoms were 2.5% (33 patients), 1.0% (5 patients) and 3.4% (28 patients). Alarm symptoms (odds ratios 3.98; confidence interval 2.47-6.41), age (1.07/year; 1.05-1.09) and male gender (1.95; 1.22-3.12) were significantly associated with gastrointestinal malignancy.
  
  
  CONCLUSIONS
  The total number of malignancies in the primary care open-access gastroscopy series was low. Alarm symptoms increased the risk 5-6-fold; such patients should therefore undergo endoscopy without delay. At a further one year of age the risk was increased by 7%, but no definite age limit for endoscopy could be asserted.
authors.affiliation: Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland.
authors.forename: Maarit
authors.initials: M
authors.lastname: Salo
authors.forename: Pekka
authors.initials: P
authors.lastname: Collin
authors.forename: Sinikka
authors.initials: S
authors.lastname: Kyrönpalo
authors.forename: Martin
authors.initials: M
authors.lastname: Rasmussen
authors.forename: Heini
authors.initials: H
authors.lastname: Huhtala
authors.forename: Katri
authors.initials: K
authors.lastname: Kaukinen
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000209:etiology; D002648:Child; D003680:Deglutition Disorders / Q000209:etiology; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D005770:Gastrointestinal Neoplasms / Q000150:complications / Q000175:diagnosis*; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D014839:Vomiting / Q000209:etiology; D015431:Weight Loss